Cubeddu Luigi X
Department of Pharmaceutical Sciences, Health Professions Division, College of Pharmacy, Nova SE University, Davie, FL 33328, USA.
Bioimpacts. 2023;13(5):355-358. doi: 10.34172/bi.2023.27552. Epub 2023 Jun 21.
Salt sensitivity defines a state characterized by a highly reactive blood pressure to changes in salt intake. The salt-sensitive phenotype is strongly associated with hypertension, visceral adiposity/metabolic syndrome, and ageing. Obesity accounts for around 70% of hypertension in young adults, and 30% to 50% of adult hypertensives carry the salt-sensitive phenotype. It is estimated that the salt-sensitive phenotype is responsible for high blood pressure in over 600 million adults. But is the salt-sensitive phenotype correctable? Interventional, controlled, clinical trials in obese adolescents and young obese adults, demonstrated that weight-reducing lifestyle modifications revert the salt-sensitive to the salt-resistant phenotype, and restored the faulty production of nitric oxide. Correction of the salt-sensitive phenotype lowers the blood pressure by reducing its reactivity to dietary salt. In a random sample of obese adults subjected to lifestyle modifications, those who were salt-resistant at baseline, were also normotensive and failed to further lower their blood pressure despite a 12% drop in body weight. The salt-resistant phenotype protects the metabolically healthy obese from hypertension, even if their salt consumption is comparable to that of salt-sensitive obese. In summary, at early stages, the elevated blood pressure of obesity, is determined by epigenetic changes leading to a state of salt-sensitivity.
盐敏感性定义了一种对盐摄入量变化具有高度反应性血压的状态。盐敏感表型与高血压、内脏肥胖/代谢综合征及衰老密切相关。肥胖约占年轻成年人高血压病例的70%，30%至50%的成年高血压患者具有盐敏感表型。据估计，盐敏感表型导致了超过6亿成年人的高血压。但盐敏感表型可以纠正吗？针对肥胖青少年和年轻肥胖成年人的干预性、对照临床试验表明，减重的生活方式改变可使盐敏感表型转变为盐抵抗表型，并恢复一氧化氮的异常生成。纠正盐敏感表型可通过降低其对膳食盐的反应性来降低血压。在接受生活方式改变的肥胖成年人随机样本中，那些基线时盐抵抗的人血压正常，尽管体重下降了12%，但血压未能进一步降低。盐抵抗表型可保护代谢健康的肥胖者不患高血压，即使他们的盐摄入量与盐敏感肥胖者相当。总之，在早期，肥胖导致的血压升高是由表观遗传变化决定的，进而导致盐敏感状态。
